Samantha Struble Samantha Struble Dr Thomas Merrill Dr Jennifer Kadlowec Hanna Dietrich Patrick Schornstaedt Elizabeth Figueiredo Dr Anil Attaluri Need Statement The current procedures instigate inefficiencies in provider time and excess patient complications with NG tubes ID: 932985
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Accurately measuring the length and placement of NG tube
Samantha Struble
Samantha Struble
Dr. Thomas Merrill, Dr. Jennifer
Kadlowec, Hanna Dietrich, Patrick Schornstaedt, Elizabeth Figueiredo, Dr. Anil Attaluri
Need Statement
The current procedures instigate inefficiencies in provider time and excess patient complications with NG tubes
There is a need to better approximate the
Dobhoff
tube length before inserting the nasogastric tube to ensure correct placement to reduce patient complications by 20%.
Problem Statement
Existing Solutions
Inefficient
X-Ray
Unreliable
Dislodgment of NG tube after image
Misinterpretation of images
Expensive Exposure to radiation
pH Test Strips
45.7% aspiration was not achieved
54% NG tube insertions required x-ray confirmation Difficult to useEasily misread
Stakeholder Analysis
Patients
Hospital
Investors
Reduce discomfort from insertion
Reduce reinsertions of NG tube
Reduce cost of litigation from misplaced tube
Market Analysis
Market Size:In the U.S, 1.2 million tubes are placed in patients every year. Half a million tubes are misplaced every yearMisplaced tubes are typically misguided into the lungs, which causes significant morbidity and mortality and costs medical providers millions of dollarsThe nasogastric market will grow due to increasing disease rates, number of preterm births, and population.
Need Criteria
Absolute
Improve rate of safe feeding
Improve accuracy of placement
Reduce patient complications Improve detection rate for misplaced tube Studies show between 2% and 4% of all tubes are misplaced.
References:
Hanna
, G., Phillips, L., Priest, O., & Ni, Z. (2010). Improving the safety of nasogastric feeding tube insertion Developing guidelines for the safe verification of feeding tube position-a decision analysis approach A Report for the NHS Patient Safety Research Portfolio. Retrieved from
https://www.birmingham.ac.uk/Documents/college-mds/haps/projects/cfhep/psrp/finalreports/PS048ImprovingthesafetyofnasogastricfeedingtubeinsertionREVISEDHannaetal.pdf Holland, A., Smith, F., & Penny, K. (2013). Carbon dioxide detection for testing nasogastric tube placement in adults. Cochrane Database of Systematic Reviews. http://doi.org/10.1002/14651858.CD010773 de Aguilar-Nascimento, J. E., & Kudsk, K. A. (2007). Clinical Costs of Feeding Tube Placement. Journal of Parenteral and Enteral Nutrition, 31(4), 269–273. https://doi.org/10.1177/0148607107031004269Misplaced NG tubes a major patient safety risk | 2015-03-20 | AHC Media: Continuing Medical Education Publishing. (2015). Retrieved July 12, 2018, from https://www.ahcmedia.com/articles/135136-misplaced-ng-tubes-a-major-patient-safety-riskWilliams, S., & McDavid, G. (2012). Nasogastric tube errors. Retrieved July 9, 2018, from https://www.medicalprotection.org/newzealand/casebook/casebook-september-2012/nasogastric-tube-errorsNational University of Singapore. (2018). Nasogastric TUbe: Being At The Right Place At The Right Time. Retrieved July 9, 2018, from http://enterprise.nus.edu.sg/technology-commercialisation/for-industry/technology-highlights/nasogastric-tube “Nasogastric Tube Market.” Yoga Pants Market - Global Industry Analysis and Forecast 2026, Transparency Market Research , 2018, www.transparencymarketresearch.com/nasogastric-tube-market.html.Srivastava, M., & Jaiswai, P. (2018). Enteral Feeding Devices Market Size, Share & Industry Forecast - 2025. Retrieved July 9, 2018, from https://www.alliedmarketresearch.com/enteral-feeding-devices-marketWalsh, K., Schub, E., Caple, C., & Pravikoff, D. (2016). NURSING PRACTICE & SKILL Reviewers Editor Nasogastric Tube: Inserting and Verifying Placement in the Adult Patient What is Involved in Inserting and Verifying Placement of a Nasogastric Tube in the Adult Patient? Cole, E. (2015). Improving the documentation of nasogastric tube insertion and adherence to local enteral nutrition guidelines. BMJ Quality Improvement Reports, 4(1), u203207.w1513. https://doi.org/10.1136/bmjquality.u203207.w1513Saunders, R. J., & Ozols, A. A. (2015). American Association of Critical-Care Nurses Practice Alert. Verification of Feeding Tube Placement. Nutrition. Nutrition in Clinical Practice, 115(8), 1868–74. Retrieved from http://www.feedingtubeawareness.org/tube-feeding-basics/tests-conditions/condition-list/
Optional
Reduce need for repeat insertions for NG tubeReduce cost of litigations to save providers moneyFrom 2001 to 2011, medical providers in the Chicago area alone paid more than $10 million to resolve lawsuits filed for injuries and deaths caused by misplaced NG feeding and suction tubes.
Whoosh Test
Unreliable for tube placementNot time efficient